Amanda Martin, is a medicare enrolled "Social Worker - Clinical" provider in San Dimas, California. Her current practice location is
762 Cypress St, San Dimas, California. You can reach out to her office (for appointments etc.) via phone at
(909) 599-1227.
Amanda Martin is licensed to practice in California (license number 111168) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1235500091.
Healthcare Provider's Profile
| Full Name | Amanda Martin |
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| Gender | Female |
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| Speciality | Social Worker - Clinical |
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| Location | 762 Cypress St, San Dimas, California |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1235500091
- Provider Enumeration Date: 10/19/2015
- Last Update Date: 01/09/2023
Medicare PECOS Information:
- PECOS PAC ID: 2860863867
- Enrollment ID: I20230131001400
Medical Identifiers
Medical identifiers for Amanda Martin such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1235500091 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101YM0800X | Counselor - Mental Health | 89378 (California) | Secondary |
| 225C00000X | Rehabilitation Counselor | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | 111168 (California) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Amanda Martin allows following entities to bill medicare on her behalf.
| Entity Name | Grow Healthcare Group Pc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1154994846
PECOS PAC ID: 1850774746
Enrollment ID: O20220809004080 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Amanda Martin is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Amanda Martin,
762 Cypress St # 107,
San Dimas, CA 91773-3505
Ph: (909) 599-1227 | Amanda Martin,
762 Cypress St,
San Dimas, CA 91773
Ph: (909) 599-1227 |
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